The Disposable Supreme Laryngeal Mask Airway
with an Esophageal Vent
Ernst Zadrobilek, MD1
of Anesthesia and Intensive Care, Chairman of the Austrian Working
Group for Airway Management and Director of the Department of Anesthesia and Intensive Care, Empress Elisabeth Hospital of the City of
Address correspondence and comments to Ernst
Received from the
Department of Anesthesia
and Intensive Care, Empress Elisabeth Hospital
of the City of Vienna, Vienna, Austria.
Published: June 30, 2007.
The correct citation of this
communiction of new equipment and techniques is:
Zadrobilek E. The disposable Supreme Laryngeal Mask Airway with an
esophageal vent. Internet Journal of Airway Management
Available from URL:
Date accessed: month day, year.
updated: December 20, 2007.
The reusable Proseal Laryngeal Mask Airway (PLMA; manufactured by the
Laryngeal Mask Company Limited, Le Rocher, Victoria, Mahe,
Seychelles) with an esophageal drain tube (DT) has replaced
the tracheal tube for airway management in many surgical procedures and may serve as a
rescue device in situations of difficult face-mask ventilation
and conventional tracheal intubation (1, 3).
The Supreme Laryngeal Mask Airway (SLMA)
was recently released by the same manufacturer as the disposable
variant of the PLMA. The SLMA (made of polyvinyl chloride and
moulded in a single unit, packaged sterile with a protective
plastic case for the cuff) is currently available in the sizes 3
The SLMA has a precurved cuff (larger than that of the PLMA, but
without a second cuff attached to the dorsal face of the mask), a
drain tube (DT; serving as esophageal vent), and an integrated bite
block. The airway tube (AT) is elliptical (following the pharyngeal
anatomy), flattened, and stiffened, and the distal cuff edge of
the mask is reinforced
(resisting folding), features designed for easier insertion and reliable placement
of the device into the correct position. The DT is placed in the
midline, passing through the AT, and ends at the distal tip of
Manual insertion of
SLMA may be probably easier and placement into the correct
position more reliable than with the PLMA.
Unfortunately, there are
currently no studies available on the clinical use and
performance of the SLMA. The disposable SMLA may replace the reusable PLMA for use as a reliable supraglottic airway
for ventilation, but this device is not suitable as an unique
dedicated airway (2) because of the small
and restricted lumen of the AT (unsuitable for tracheal
inubation, even with a flexible fiberoptic laryngoscope mounted
with an intubating catheter).
The costs of the
SLMA are about 19 Euro (exclusive
value-added taxes, according to the offer of the Austrian
distributor, queried in December 2007).
JR. ProSeal LMA for ventilation and airway protection. In: Brimacombe JR
(ed) Laryngeal mask anesthesia. Principles and practice. Saunders,
Philadelphia, p 505-537, 2005.
P, O'Sullivan E. The 'dedicated airway': a review of a concept and an update
of current practice. Anaesthesia
Lee G, Nolan JP. The ProSealTM laryngeal mask airway: a
review of the literature.
Can J Anesth 52:739-760, 2005.